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State Organizations
The State Organization Index provides an alphabetical listing of government organizations, including commissions, departments, and bureaus.

State Organizations
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Unemployment Online

Child Support Enforcement

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Search terms

State Organizations
The State Organization Index provides an alphabetical listing of government organizations, including commissions, departments, and bureaus.

State Organizations
Log In to...
Top-requested sites to log in to services provided by the state

Virtual Gateway

Unemployment Online

Child Support Enforcement

offered by

Public Employee Retirement Administration Commission

related to

Public Retirement Benefits

PERAC General Membership Forms

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Table of Contents

Table of Contents

Member Benefit Forms

Open PDF file, 15.63 KB, for Authorization to Use or Disclose Protected Health Information (PDF 15.63 KB)

Open PDF file, 60.32 KB, for Beneficiary Change Form (PDF 60.32 KB)

Open PDF file, 93.17 KB, for Beneficiary Selection Form (PDF 93.17 KB)

Open PDF file, 126.97 KB, for Disability Application Glossary of Terms (PDF 126.97 KB)

Open PDF file, 540.47 KB, for Disability Retiree Earned Income Worksheet (PDF 540.47 KB)

Open PDF file, 322.17 KB, for Disability Retirement Application Form (PDF 322.17 KB)

Open PDF file, 104.73 KB, for Disability Retirement Benefits for Veterans (PDF 104.73 KB)

Open PDF file, 58.55 KB, for Instructions for Submitting the Annual Statement of Earned Income (PDF 58.55 KB)

Open PDF file, 59.38 KB, for Lump Sum Distributions: Special Tax Notice (PDF 59.38 KB)

Open PDF file, 58.03 KB, for Memorandum #17 Attachment 1 (PDF 58.03 KB)

Open PDF file, 132.85 KB, for New Member Enrollment Form (PDF 132.85 KB)

Open PDF file, 71.28 KB, for Pre-Tax Rollover Form (PDF 71.28 KB)

Open PDF file, 217.06 KB, for Refund Application (PDF 217.06 KB)

Open PDF file, 209.38 KB, for Retirement Application (voluntary superannuation) (PDF 209.38 KB)

Open PDF file, 119.73 KB, for Retirement Option Selection Form (PDF 119.73 KB)

Open PDF file, 173.25 KB, for Statement Concerning Your Employment in a Job Not Covered by Social Security (PDF 173.25 KB)

Open PDF file, 165.11 KB, for Veterans' Buyback Form (PDF 165.11 KB)

Survivor Benefit Forms

Open PDF file, 91.47 KB, for Application for Member Survivor Benefits (PDF 91.47 KB)

Open PDF file, 105.32 KB, for Notice of Election of Benefits under 12(2)(d) (PDF 105.32 KB)

Open PDF file, 103.71 KB, for Spousal Affidavit to Determine Benefit Eligibility (PDF 103.71 KB)

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